Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study

Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining w...
Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Markovic, Danica [verfasserIn] Jevtovic-Stoimenov, Tatjana Stojanovic, Milena Vukovic, Anita Dinic, Vesna Markovic-Zivkovic, Bojana Jankovic, Radmilo J.

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2017

Schlagwörter:	Care Preoperative Mortality In Hospital ACS-NSQIP ASA SORT

Anmerkung:	© European Geriatric Medicine Society 2017

Übergeordnetes Werk:	Enthalten in: European geriatric medicine - [Cham] : Springer International Publishing, 2010, 9(2017), 1 vom: 21. Dez., Seite 51-59
Übergeordnetes Werk:	volume:9 ; year:2017 ; number:1 ; day:21 ; month:12 ; pages:51-59

Links:	Volltext

DOI / URN:	10.1007/s41999-017-0002-6

Katalog-ID:	SPR038400340

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520			\|a Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed.
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allfields	10.1007/s41999-017-0002-6 doi (DE-627)SPR038400340 (SPR)s41999-017-0002-6-e DE-627 ger DE-627 rakwb eng Markovic, Danica verfasserin (orcid)0000-0001-9472-8868 aut Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Geriatric Medicine Society 2017 Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. Care (dpeaa)DE-He213 Preoperative (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 In Hospital (dpeaa)DE-He213 ACS-NSQIP (dpeaa)DE-He213 ASA (dpeaa)DE-He213 SORT (dpeaa)DE-He213 Jevtovic-Stoimenov, Tatjana aut Stojanovic, Milena aut Vukovic, Anita aut Dinic, Vesna aut Markovic-Zivkovic, Bojana aut Jankovic, Radmilo J. aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 9(2017), 1 vom: 21. Dez., Seite 51-59 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:9 year:2017 number:1 day:21 month:12 pages:51-59 https://dx.doi.org/10.1007/s41999-017-0002-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2111 GBV_ILN_2153 GBV_ILN_4251 AR 9 2017 1 21 12 51-59
spelling	10.1007/s41999-017-0002-6 doi (DE-627)SPR038400340 (SPR)s41999-017-0002-6-e DE-627 ger DE-627 rakwb eng Markovic, Danica verfasserin (orcid)0000-0001-9472-8868 aut Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Geriatric Medicine Society 2017 Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. Care (dpeaa)DE-He213 Preoperative (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 In Hospital (dpeaa)DE-He213 ACS-NSQIP (dpeaa)DE-He213 ASA (dpeaa)DE-He213 SORT (dpeaa)DE-He213 Jevtovic-Stoimenov, Tatjana aut Stojanovic, Milena aut Vukovic, Anita aut Dinic, Vesna aut Markovic-Zivkovic, Bojana aut Jankovic, Radmilo J. aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 9(2017), 1 vom: 21. Dez., Seite 51-59 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:9 year:2017 number:1 day:21 month:12 pages:51-59 https://dx.doi.org/10.1007/s41999-017-0002-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2111 GBV_ILN_2153 GBV_ILN_4251 AR 9 2017 1 21 12 51-59
allfields_unstemmed	10.1007/s41999-017-0002-6 doi (DE-627)SPR038400340 (SPR)s41999-017-0002-6-e DE-627 ger DE-627 rakwb eng Markovic, Danica verfasserin (orcid)0000-0001-9472-8868 aut Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Geriatric Medicine Society 2017 Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. Care (dpeaa)DE-He213 Preoperative (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 In Hospital (dpeaa)DE-He213 ACS-NSQIP (dpeaa)DE-He213 ASA (dpeaa)DE-He213 SORT (dpeaa)DE-He213 Jevtovic-Stoimenov, Tatjana aut Stojanovic, Milena aut Vukovic, Anita aut Dinic, Vesna aut Markovic-Zivkovic, Bojana aut Jankovic, Radmilo J. aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 9(2017), 1 vom: 21. Dez., Seite 51-59 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:9 year:2017 number:1 day:21 month:12 pages:51-59 https://dx.doi.org/10.1007/s41999-017-0002-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2111 GBV_ILN_2153 GBV_ILN_4251 AR 9 2017 1 21 12 51-59
allfieldsGer	10.1007/s41999-017-0002-6 doi (DE-627)SPR038400340 (SPR)s41999-017-0002-6-e DE-627 ger DE-627 rakwb eng Markovic, Danica verfasserin (orcid)0000-0001-9472-8868 aut Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Geriatric Medicine Society 2017 Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. Care (dpeaa)DE-He213 Preoperative (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 In Hospital (dpeaa)DE-He213 ACS-NSQIP (dpeaa)DE-He213 ASA (dpeaa)DE-He213 SORT (dpeaa)DE-He213 Jevtovic-Stoimenov, Tatjana aut Stojanovic, Milena aut Vukovic, Anita aut Dinic, Vesna aut Markovic-Zivkovic, Bojana aut Jankovic, Radmilo J. aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 9(2017), 1 vom: 21. Dez., Seite 51-59 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:9 year:2017 number:1 day:21 month:12 pages:51-59 https://dx.doi.org/10.1007/s41999-017-0002-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2111 GBV_ILN_2153 GBV_ILN_4251 AR 9 2017 1 21 12 51-59
allfieldsSound	10.1007/s41999-017-0002-6 doi (DE-627)SPR038400340 (SPR)s41999-017-0002-6-e DE-627 ger DE-627 rakwb eng Markovic, Danica verfasserin (orcid)0000-0001-9472-8868 aut Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study 2017 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier © European Geriatric Medicine Society 2017 Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. Care (dpeaa)DE-He213 Preoperative (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 In Hospital (dpeaa)DE-He213 ACS-NSQIP (dpeaa)DE-He213 ASA (dpeaa)DE-He213 SORT (dpeaa)DE-He213 Jevtovic-Stoimenov, Tatjana aut Stojanovic, Milena aut Vukovic, Anita aut Dinic, Vesna aut Markovic-Zivkovic, Bojana aut Jankovic, Radmilo J. aut Enthalten in European geriatric medicine [Cham] : Springer International Publishing, 2010 9(2017), 1 vom: 21. Dez., Seite 51-59 (DE-627)627611737 (DE-600)2556794-9 1878-7657 nnns volume:9 year:2017 number:1 day:21 month:12 pages:51-59 https://dx.doi.org/10.1007/s41999-017-0002-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_63 GBV_ILN_65 GBV_ILN_69 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_101 GBV_ILN_105 GBV_ILN_110 GBV_ILN_224 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2004 GBV_ILN_2005 GBV_ILN_2025 GBV_ILN_2034 GBV_ILN_2044 GBV_ILN_2048 GBV_ILN_2064 GBV_ILN_2111 GBV_ILN_2153 GBV_ILN_4251 AR 9 2017 1 21 12 51-59
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When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. 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author	Markovic, Danica
spellingShingle	Markovic, Danica misc Care misc Preoperative misc Mortality misc In Hospital misc ACS-NSQIP misc ASA misc SORT Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study
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topic_title	Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study Care (dpeaa)DE-He213 Preoperative (dpeaa)DE-He213 Mortality (dpeaa)DE-He213 In Hospital (dpeaa)DE-He213 ACS-NSQIP (dpeaa)DE-He213 ASA (dpeaa)DE-He213 SORT (dpeaa)DE-He213
topic	misc Care misc Preoperative misc Mortality misc In Hospital misc ACS-NSQIP misc ASA misc SORT
topic_unstemmed	misc Care misc Preoperative misc Mortality misc In Hospital misc ACS-NSQIP misc ASA misc SORT
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title	Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study
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title_full	Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study
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author_browse	Markovic, Danica Jevtovic-Stoimenov, Tatjana Stojanovic, Milena Vukovic, Anita Dinic, Vesna Markovic-Zivkovic, Bojana Jankovic, Radmilo J.
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title_sort	addition of clinical risk scores improves prediction performance of american society of anesthesiologists (asa) physical status classification for postoperative mortality in older patients: a pilot study
title_auth	Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study
abstract	Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. © European Geriatric Medicine Society 2017
abstractGer	Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. © European Geriatric Medicine Society 2017
abstract_unstemmed	Purpose Many methods for preoperative risk stratifications used in everyday practice do not take into account all of the comorbidities and complex physiological status of older patients. Therefore, anaesthesiologists and surgeons must consider multiple ways of preoperative diagnostics. Determining which of the preoperative clinical risk scores [Revised Lee score, the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) calculator and Surgical Outcome Risk Tool (SORT)] best improves routinely used American Society of Anaesthesiologists (ASA) physical status classification. Methods The prospective pilot study included 78 patients who were being prepared for extensive non-cardiac surgeries under general anaesthesia. Preoperatively, anaesthesiologist determined ASA score according to guidelines. Then, the data of patients have been processed on the interactive calculators of Revised Lee score, ACS NSQIP and SORT. Results Mean age of included patients was 71.4 ± 6.9 years. When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. Further studies, with a greater number of patients, are needed. © European Geriatric Medicine Society 2017
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title_short	Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study
url	https://dx.doi.org/10.1007/s41999-017-0002-6
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author2	Jevtovic-Stoimenov, Tatjana Stojanovic, Milena Vukovic, Anita Dinic, Vesna Markovic-Zivkovic, Bojana Jankovic, Radmilo J.
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When it comes to postoperative mortality prediction, three risk scores (ASA, ACS NSQIP and SORT) have been statistically significant, respectively, P = 0.016, P < 0.0001, P < 0.0001. Results showed that AUC being higher in ACS NSQIP and SORT (0.813; 0.797). Out of all three additional risk scores, ACS NSQIP showed to add the most to the specificity and sensitivity of ASA score, with combined AUC = 0.841. Conclusions ACS NSQIP and SORT increase the accuracy of ASA score. Revised Lee score cannot be considered a good indicator of postoperative mortality risk since it is primarily the score which indicates risk for cardiovascular complications. 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Addition of clinical risk scores improves prediction performance of American Society of Anesthesiologists (ASA) physical status classification for postoperative mortality in older patients: a pilot study

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